Are We Prepared for Pandemics?
By Nadav Morag, Ph.D.
CTU’s Global Security Series offers background on current national and homeland security topics. In this series, Dr. Morag focuses on an often unaddressed area of homeland security: pandemics and its impact on public health. In this fourth installment, Dr. Morag surveys the variety of people, systems and processes that need to coordinate to minimize the risk and spread of a pandemic.
Despite our knowledge that a pandemic outbreak could claim hundreds to millions of lives, it is not clear whether existing systems can cope with a particularly nasty outbreak.
The following is a survey of some major issues that need to be addressed in planning for pandemics if we hope to lessen its impact and foster societal resilience:
Business Continuity – In addition to being a threat to the health of the population, pandemics also represent a significant economic threat because large numbers of incapacitated or deceased persons means a potentially significant drop in the productivity and functioning of the economy. Vital for large and small businesses is a pandemic response plan that enables operations to continue, even at a minimal level. That plan may include:
- Defining roles and responsibilities for planning
- Identifying critical activities in the business that must be staffed under all conditions
- Cross-training workers so that they can fill other roles as needed
- Conducting risk assessments to determine the parts of the business most likely to be vulnerable and the potential impact
- Assessing the impact of local, national or global travel restrictions on the functioning of the business
- Creating a communications plan for company employees to provide up-to-date information and instructions.
First Responder Community – The first responder community is vital in serving needs that range from emergency medical services providing transportation to medical facilities, to law enforcement operating in a crowd control, traffic and quarantine enforcement capacity. This requires trained first responders capable of managing pandemic scenarios. They also need the appropriate equipment to protect them from disease agents transmitted through the air. Additionally, the issue of first responder absenteeism must be addressed. Panic that often ensues with the outbreak of a major pandemic can create pressure on first responders to stay with their families or avoid work for fear of being infected.
Transportation and Borders – The transportation sector must prepare contingencies to manage restrictions to the movement of persons and goods. The transportation network, which includes, land, maritime and air borders, plays a critical role in slowing the spread of a pandemic. Steps must be taken to limit person-to-person contact, which naturally limits the freedom of movement via transportation networks.
Syndromic Surveillance and Diagnostic Testing – The U.S. public health system is underfinanced and incapable of effectively accomplishing all of its missions. This means that when a pandemic occurs, it may not be spotted for some time because the cost of effective diagnostic tests is prohibitive. Also, the ability to collate and analyze the massive amount of information coming in from clinics, hospitals and other health care facilities about an outbreak is not optimal. Better coordination between local, federal and international agencies is needed.
Prophylaxis and Treatment – Public health systems will need to ensure their plans for the provision of vaccines to prevent, and/or medications to treat, pandemic outbreaks are up-to-date and effective. The cycle between development and production will need to be vastly more efficient. In addition, getting the vaccine or medication to distribution points requires considerable planning, from proper administration and managing adequate supply levels, to ensuring public order at dispensing sites.
The Health Care System – The cost to truly prepare for a major disease outbreak is prohibitive and the medical system is unlikely to ever have the capacity to cope with the potential number of sick individuals that could inundate clinics and hospitals. In the case of a pandemic, the best approach is to provide as many health care resources to an affected area as quickly as possible, and preferably have dual-use personnel and facilities available. This means all medical personnel must be trained to play emergency roles in the event of a pandemic, and hospitals and other health care facilities must find ways to quickly scale resources.
As this brief overview illustrates, pandemic preparedness and planning is extremely complex and is dependent on a variety of systems, processes and personnel roles. Needless to say, if any of these fail during a major pandemic, the result will be greater loss of human life and, though this is clearly less important, significant negative economic impact.
Image credit: Flickr/Nathan Reading